移植肾脏病临床特点与病理类型的相关性分析  

The correlation analysis of clinical characteristics and pathological types of allograft nephropathy

作　　者：王锁刚[1] 李伟[1] 翟琼瑶 卢鹏 迟凯凯[1] 王光策[1] WANG Suo-gang;LI Wei;ZHAI Qiong-yao(The First Ward of Urology,the First Affiliated Hospital of Henan University of CM,Zhengzhou450003,China)

机构地区：[1]河南中医药大学第一附属医院泌尿外科一病区,河南郑州450003

出　　处：《中国实验诊断学》2021年第9期1280-1285,共6页Chinese Journal of Laboratory Diagnosis

基　　金：河南省中医药科学研究专项课题(2018ZY2077)。

摘　　要：目的探讨移植肾脏病临床特点及与病理类型相关性,为移植肾脏病的个体化治疗及评估预后提供依据。方法回顾性分析332例移植肾脏病患者病例资料,总结临床特点,依据Banff2007标准进行病理诊断及分类,并分析临床特点与病理类型的相关性。结果移植肾脏病临床表现为无尿或少尿、血尿、蛋白尿、水肿、高血压、移植肾肿胀疼痛、肾功能异常等;临床症候群分布为无尿或少尿型6.02%、隐匿性肾炎型9.04%、肾炎综合征型17.17%、肾病综合征型22.89%、肾功能不全型44.88%;肾移植围术期移植肾病理表现为超急性排斥反应、加速性排斥反应;肾移植近期移植肾病理多表现为急性细胞性排斥反应、急性体液性排斥反应、急性肾小管坏死等;肾移植远期移植肾病理以慢性病变多见,原肾病复发也占一定的比例;亦可见少数感染性相关肾损伤及其他类型等。结论移植肾脏病的临床特点和病理类型呈多样性,但二者之间具有一定的相关性,症状越复杂,移植肾病理损伤程度越重。探讨移植肾脏病的临床特点和病理类型的相关性对指导临床个体化、规范化治疗及判断预后具有非常重要的参考价值。Objective To explore the correlation between the clinical characteristics and pathological types of allograft nephropathy,and to provide a basis for the diagnosis,treatment and prognosis of allograft nephropathy.Methods 332cases of patients with allograft nephropathy underwent renal biopsy were retrospectively analyzed.The clinical characteristics were summarized,histopathological manifestations of transplanted kidney were observed,pathological diagnosis and classification were conducted according to Banff2007standard,and the correlation between clinical and pathology was analyzed.Results The clinical manifestations of allograft nephropathy are anuria or oliguria,hematuria,proteinuria,edema,hypertension,swelling and pain of transplanted kidney,abnormal renal function.The distribution of clinical symptoms was anuria or oliguria type 6.02%,occult nephritis type 9.04%,nephritis syndrome type 17.17%,nephrotic syndrome type 22.89%,renal insufficiency type 44.88%.Perioperative stage of kidney transplantation was characterized by hyperacute rejection and accelerated rejection.Early stage of kidney transplantation was characterized by acute cellular rejection,acute humoral rejection,and acute tubular necrosis.Long-term of kidney transplantation,the pathology of kidney transplantation disease is mainly characterized by chronic diseases,the primary recurrence also accounted for a certain proportion.A few infection-related renal injuries and other types were also observed.Conclusion The clinical characteristics and pathological types of allograft nephropathy are diverse.There is a close positive correlation between the clinical characteristics and pathological types of allograft nephropathy.The more severe the symptoms,the more severe the pathological damage of the transplanted kidney.To investigate the correlation between clinical characteristics and pathological types of renal graft disease is of great reference value for individualized and standardized clinical treatment and prognosis judgment.

关 键 词：移植肾脏病 临床特点 病理学特征 相关性 

分 类 号：R699.2[医药卫生—泌尿科学]